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HomeMy WebLinkAboutH2022-0525 - Permits�E`%�PORT City of Newport Beach III I I I II I II I II III I I II I II p� 6� Community Development Department- Building Division Mechanical Permit F `�' 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: G } z Permit Counter Phone: (949) 644-3288 Work Class : Other m< Inspection Requests Phone: (949) 644-3255 ogaFoaN�� newportbeachca.govfjnspections Issued Date : Inspection Area : 5 H2O22-0525 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 452 CABRILLO TER Legal Desc : N TR:1237 BLK LOT 82 Description: MECH - R/R FURNACE Owner: PUCHNER ALEXANDER MARK TR Co Address : 452 CABRILLO TER CORONA DEL MAR, CA 92625 Ad Phone: ph Co Applicant: BEN MEDINA Lic Address : 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Bu Phone : (818) 735-7876 Bu We Owner/Builder : Ca Address: Po Phone: ',W Code Edition : 2019 Fire Hazard Zone : NO Type of Construction Occupancy Groups: Building Setbacks : Front: 5, Front: 15, Side: 6, Side: 6 " Flood Zone : X Use Zone : R-1-6000 - Single -Unit Residential PROCESSED BY: CA SPECIAL CONDITIONS: a©° a a °°. o° ° ° idlcates minimum lot area) actor i. GOE' ss : 532 N ,(714) tate Lic : 104T pire 12/31 is : BT30 is Expire:02/28 ors' Compensal r: STAF No: 1000( Expire`: 12/1/: R CONDITIONING & PLUMBING Y COURT CORONA, CA 92880 & LIABILITY CO Manufacturer Model# : I hereby affirm under penalty of perjury. that I am exempt from the Contractors' State. License Law for the reason(s).indicated below by the checkmark(s) I have. placed next to the applicable items) Chon 7031.5, Business and Professions Cade: Any city or county that requires permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance; also requires the applicant for permit to File a signed statement that he or she is licensed pursuantto the provisions of the: Contractors' State License Law (Chapter n (commencing with Section 7000) of Division 3.of the Business and Ifessions Code) or that he or she is exempt from licer sure and the basis for the: alleged exemption. Anyvlolation of Section 7031.5 by any applicant for a permit. subjects the applicant to a civil penalty of more than five hundred dollars ($504). I, as owner of the property, or my employees with wag" as ibeirsole compensation, will do U all of or U portions of: the work; and the structure Is not intended oroffered for sale: (Section 7044, >iness and Professions Code: The Contractors State License Law doesriot apply to an: owner of property who, through+employees' or personal effort, builds or improves the: property,.. provided that the Movements aria not intended or offered for sale. If, however, the building or improvement is sold within one-year of completion, the Owner -Builder will have the burden of proving that it -was not built or Proved for the purpose of sate). 1; as owner of the property,: am exclusively contracting With. licensed Contractors to construct the project (Section 7044, Business and Professions Code., The Contractors' State License. Law does not. Ply to an owner of property -who builds or Improves thereon, and who contracts for the projects. with a licensed Contractor pursuant to the Contractors' State License Law): I am exempt from licensure under the Contractors' State license taw for the following reason: my signature. below 1 acknowledge that, except for my personal residence in which I must have resided for at [east one year prior to completion of the improvements covered by this permit I:cannot legal a structure that I have built as an owner -builder if it has not been Constructed in its entirety by licensed contractors. I understand that copy of the applicable_ law, Section 7W of the Business and. Ifessions Code, Is available upon request when this application Is submitted of at the following Web site:http:llHnvw.leginfo.ca.govlcalaw.html. nature of Pmcedv Owner or AuthorizedAdam_. _.._. __.. _.Date.__._�— I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter $:(commencing With Section 700 �f DhA i_p tit the Business and Prof 'sib d my license is in full force and effect. License Class License: No Da Gfi Contractor Signatu iNORKERS' COMPENSATION DECLARATION NANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIYR: PINES UP TO ONE HUNDRED THOUSAND DOLLARS {¢10Q,00D). IN. ADDDION TO TI COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST; AND ATTORNEY'$ FEES. I hereby affirm. under penalty of perjury one of the following declarations_ 1 have and will maintain a certif'ieste of consent to self -insure for workers' compensation, issuedby the. Directorof industrial Relations as provided for by Section 3700:of the Labor Code, for Off mane of the work for which this permit is issued.: Policy No. and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of thework for which this: permit is issued. My workers' compensat ranee carrier and policy number are: of Agent in the performance of the become subject to the we 1119 Policy Number I am the property owner or authorized to: act on the prc I have road this apptication and the information f have I agree to comply With all;appl#cable city and county or (.authorize representatives of this city or county tIj enti ACTION ( DATE Is -d is correct. PART 61 Etc Date )nir any manner so'as to become subject to the workers` compensation laws of California, and agre ]e; I shall forthwith comply with those provisions. DAL&# the work for which this permit is issued (Section 3097, Civil Code), to building construction. rr inspection purposes. FEDERAL IFOR PERMITFINAL U ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF + I—a':PROPOSED DEMOLITION. OCCUPANCY ISSUED .SIGNATURE: M1 • • • • • • • • • • • • s o e � • • o oa o mea o0 0o e o oov oe